Individual
MEGAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
100 VISTA DR, MOUNT VERNON, IN 47620-1266
(812) 838-6558
(812) 422-7558
Mailing address
415 MULBERRY ST, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006964A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000871089
ANTHEM
IN
05
—
100240880
—
IN
01
—
12688390
CAQH
—
01
—
839090008
MEDICARE
IN
Enumeration date
02/28/2011
Last updated
03/22/2022
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